[Remoxipride, a selective antagonist of dopamine D2 receptors, in the treatment of delusional psychoses]

Abstract

Remoxipride, a substituted benzamide, is a new antipsychotic agent which differs from classical neuroleptics in several ways. It has a selective action on the dopamine D2 receptors in the brain and little effect on a variety of other receptor types including serotonin, noradrenaline, acetylcholine and histamine receptors. This implies advantages over classical neuroleptics which have less selective modes of action and subsequently increased propensities to cause side effects. The pharmacokinetics of remoxipride are uncomplicated. The drug is rapidly absorbed, plasma levels increase with dose, and elimination is via urinary excretion. No clinically significant drug interactions have been found. Remoxipride has been shown to be as effective in the treatment of schizophrenic patients as haloperidol in both short and long term double-blind trials. Both positive and negative symptoms are improved. However, remoxipride shows advantages over haloperidol in that the incidences of extrapyramidal symptoms and increased plasma prolactin concentrations are lower in remoxipride recipients. There are no clinically relevant adverse effects on chemistry, haematology or cardiovascular variables.